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Post-traumatic stress disorder: a review of psychobiology and pharmacotherapy
I Hageman1, H S Andersen, M B Jørgensen
1Department of Psychiatry, Righospitalet, DK-2100 Copenhagen, Denmark.
Objective:
To review the literature on the psychobiology and pharmacotherapy of PTSD.
Methods:
Relevant studies were identified by literature searches (Pub-med, Web of Science) and through reference lists. The search was ended by May 2001.
Results:
There is evidence of involvement of opioid, glutamatergic, GABAergic, noradrenergic, serotonergic and neuroendocrine pathways in the pathophysiology of PTSD. Medications shown to be effective in double-blind placebo-controlled trials includes selective serotonin reuptake inhibitors, reversible and irreversible MAO-inhibitors, tricyclic antidepressants and the anticonvulsant lamotrigine. Still more agents appear promising in open-label trials.
Conclusion:
The complexity of the psychobiology is reflected by the difficulties in treating the disorder. According to the present knowledge, suggestions for drug treatment of PTSD are made.